What your breasts will look like after explantation depends on several factors such as: the quality of skin elasticity (the better the elasticity the better the skin will bounce back), the size of the implants used (the larger the implant the more trouble you may have with redundant skin), and the amount of breast tissue present at this time (which may have changed since the time of your breast augmentation).
Life experience since your breast augmentation procedure, such as pregnancy or weight gain weight loss, will potentially influence the factors discussed above. If you take these factors into consideration and apply them to your specific circumstances you may get a good idea of what to expect after the implants are removed.
Occasionally, I see patients who just want the implants removed because they don't want the implants "to be a part of them" anymore. Make sure you think about this and that this is the right thing for you. It's difficult to say if you need a lift after removal -- no one will know exactly what your breasts will look like after the implants are removed until it is done. Talk to a well-trained and experienced board-certified plastic surgeon and get good advice.
Process of breast implant removal (explantation)
In this instance, surgeons typicallyremove the implant which can be performed under local anesthesia. A period of observation proceeds to assess the need for a lift. Alternatively you could deflate the implant in place and evaluate the need for a lift two weeks later.
Breast Implant Removal/Revision Surgery
I often remove breast implants for clients wishing to upgrade their breast appearance after 15 years. The options are to remove the breast implants and no longer have the issue of the maintenance of implants or to replace the implants with the newer Mentor saline as eventually implants do wear out. If after you second baby your breast tissue is saggy and your nipple is lower than desired you would maybe consider a breast lift either with or without breast implants. Basically after talking with my clients about both of these options and advising them on how they would look after removal most often they tend to replace their implants just to have the fullness and youthful appearance. Remember breast implants both saline and silicone come in all sizes and shapes and the Mentor manufacturer has a much better selection today as was available15 years ago. Breast implant surgery removal is normally a one and half hour surgery in my practice and is done under general anesthesia. The scar tissue that is formed around the breast implant is removed so if you do not replace the implant this area will not be hard after the surgery.
Sounds like removal and a lift for you probably.
The recovery and other issues really revolve around what you have done. It is usually well tolerated really.
John Di Saia MD
Removing an old breast implant is easy.
Removal of your old saline implants is easy. Takes about 10 minutes and not scraping of bone or muscle is necessary. If your breasts need reshaping, then a mastopexy could be done concurrently. This takes about 2 hours and results in incisions you would ordinarily not have with implant removal alone.
Aesthetic result after breast implants are removed - you would benefit from a lift as well
The breast implants that had been placed have stretched out the tissue around them. When the implant is removed you will notice some sagging of the breast. If this displeases you, you may choose to have another implant put in its place or to receive a small breast lift.
It sound from your description that over the years your breast have gotten bigger and the implants are redundant now.
If you feel the breast size is too large, taking out the implant will make you smaller, the question then, are you gping to be happy with the remaining breast tissue size?
That will depend on how much breast tissue you have. That can be estimated by your plastic Surgeon.
I believe part of the "Capsule" has to be removed. There has been reports of fluid accumolation in the capsules that has been left behind. Also these capsules you have are 15 years old. The older the implant the more chance that these capsules are calcified, and they need to be removed. Removal of the capsule will make the surgery slightly longer and more involved.
Also you and the plastic surgeon has to make a decision whether you will need or desire a breast lift. and what shape the breast is going to be once the implants are removed. Also symmetry in shape and size. You have to be comfortable with that as well. See a Board Certified PS and discuss all these issues.Good luck
Saline Breast Implant Removal
Removal of your saline implants should be relatively easy unless you require a removal of a thickened capsule (capsulectomy). If the implants are soft, removal just requires deflation of the saline implants and removal via your old incision.
It sounds like you may also require a breast lift (mastopexy) because as you describe yourself you have significant ptosis or drooping of the breasts. This procedure can be performed at the same time as the implant removal.
Revision of breast implants
Your question makes the operation sound much worse than it is- there should be no scraping involved! If you had saline implants placed, they will be very easily removed. If the implants are silicone, the removal will also be very easy if they are still intact. If they have ruptured, removing of the free silicone can be a little more difficult, but involves a lot of irrigation and possibly some small amount of tissue removal.
The more significant issue will be how things look after the implants are removed. Implants that have enough volume to move you from an A to a C or D will still be providing your breasts with a mass effect, and removing them will likely cause your breast to become deflated and even lower. You will almost definitely need some type of breast lift.
While complete removal of the implants is possible it is usually best to replace the implants with a smaller version and lift the remaining tissue over the new implants. This is more likely to give an optimal aesthetic result, and the lifting can be combined with a small reduction to sculpt your breast into an excellent shape and size.
It is completely easy to remove your implants. They are not adhered to anything and no scraping is needed. It can be done under local anesthesia and there is absolutely zero recovery.
What makes the process more complex is if you need a breast lift to tighten up the lax skin. This is an operation that requires anesthesia and some recovery but not nearly as bad as the original augmentation.